Study Finds “Surprisingly” High Four-Year Mortality Rate in Polycythemia Vera Patients

In results from the prospective, observational REVEAL trial, researchers described the survival rates and causes of death among patients with polycythemia vera (PV). Lead author Carole B. Miller, MD, presented these findings at the 2021 Society of Hematologic Oncology (SOHO) 2021 Annual Meeting.

The REVEAL trial included U.S. patients with PV treated at community and academic practices. Patients were followed during usual-care visits for 36 months until death, withdrawal, or study end. High-risk patients were those aged ≥60 years, who had a history of thrombotic events, or both.

A total of 2,510 patients were enrolled between July 2014 and August 2016. Nearly 10% (n = 244) died during the study. Compared with surviving patients, patients who died during the study were older at diagnosis (mean age = 68.5 vs. 60.2 years; p < 0.001), had longer disease duration (mean = 6.5 vs. 5.7 years; p = 0.06), and were considered higher-risk (82% vs. 59.1%; p < 0.001). Deceased patients also had more comorbidities, including:

  • cardiac: 41.0% vs. 12.1%
  • blood/lymphatic: 31.1% vs. 18.5%
  • vascular: 72.1% vs. 62.3%
  • neoplasms: 47.5% vs. 22.2%
  • respiratory: 55.7% vs. 33.4%
  • infections: 41.0% vs. 26.3%

Approximately one-third of patients died from thrombotic complications, and more than one-quarter had elevated hematocrit or uncontrolled myeloproliferation in the 6 months before death. “In this large contemporary analysis of patients with PV, estimated 4-year mortality was >10%, a surprising observation given the mean age of only ~66 years,” the authors concluded.